Sport-Related Concussions

An SRC falls under the category of a traumatic brain injury. It occurs when an outside force, such as from another person or from sporting equipment, causes a direct blow to the body with a resultant force transmitted to the head. The nerve cells in the brain undergo mechanical stress, causing changes to our neurological function.

Signs and symptoms

Typically, symptoms come on quickly, and can change very rapidly within the first few hours. Anyone suspected of having an SRC should be closely monitored during this time. Symptoms are extremely varied, making it difficult to predict how a person with an SRC will feel or behave.

When in doubt, sit them out

The pace of a game can make it difficult to determine if a concussion has taken place. SRC experts recommend erring on the side of caution if one is suspected and removing the athlete from the game immediately. A licensed health care practitioner who is trained in SRC management should then evaluate the athlete on the sideline.

Sideline screening

The most established tool available for sideline use by trained professionals is the Sport Concussion Assessment Tool (SCAT5).

Individuals who are not medically trained can refer to the Concussion Recognition Tool (CRT5). Although not a substitute for medical diagnosis, the CRT5 provides guidance for recognizing a possible SRC, including when to remove an athlete from play. It can be downloaded at no cost at bjsm.bmj.com/content/51/11/872.

Immediately following injury, an athlete may not realize they’re concussed, or they may deny certain symptoms to avoid being pulled from the game. It’s crucial to remember that any player with a suspected concussion must not return to play that day.

Seeing the doctor

Every athlete should visit a physician as soon as possible to determine the extent of their injury, regardless of whether they were seen after playing or whether they are already improving. The doctor will evaluate the athlete’s neurological function, including mental status, sensation, vision, coordination, and balance.

Resting body and brain

The initial 24 to 48 hours should be spent resting from physical and mental activities, including screen time. Just like an ankle requires rest from weight-bearing activity following a sprain, the brain requires rest from mental activity after a head injury. Even tasks that don’t seem to require much effort, such as scrolling through your social media feed, exert stress on the brain and should be avoided.

Returning to school

It’s highly recommended that children return to school before they return to sport, following a strict stage-by-stage process. Students may require a temporary absence from school, and experts advise that schools accommodate students with individualized support.

Returning to sport

Return to sport is also a step-by-step process, regardless of the individual’s level of competition. The process takes a minimum of one week, with each step taking at least 24 hours. If symptoms return at any stage, the athlete must return to the previous stage until they can get through that stage without symptoms.

Recovery time

The majority of SRCs in children, adolescents, and adults resolve within four weeks. However, physical and mental symptoms may not recover at the same rate. A doctor, over several visits, can determine when both physical symptoms and mental impairments have resolved. Returning to school or sport too early increases risk of re-injury and long-term complications.

An invisible injury

An injury to the brain is often invisible to an outsider. For example, an athlete may appear fully recovered while they’re still struggling to concentrate or make decisions. This may lead to challenges at school or work and frustrations for all involved. All parties need to respect that the brain is an incredibly dynamic organ with its own timeline for healing.

Long-term effects

Former athletes of contact sports have shown an association between multiple concussions and depression and mental deficits later in life. The long-term consequences of repeat concussions are a developing area of research and one to keep our eyes on.

Holistic care

No two SRCs are ever the same, even in the case of multiple concussions within the same individual. Consider taking a holistic approach to address your individual needs. Keep an eye on your stress levels, treat any associated injuries (whiplash is common), consume nutrient-rich foods, get adequate sleep, and arrange any necessary modifications for school and work.